BONITA MARLEA SISSOM Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049276611

License Status

NOT RENEWED

Business

First Name

BONITA

Middle

MARLEA

Last Name

SISSOM

Business Name

BONITA MARLEA SISSOM

Original Issue Date

10/14/2020

Effective Date

10/14/2020

Expiration Date

03/31/2021

City

ANNA

State

Zip

62906

County

UNION

Ever Disciplined

LastModifiedDate

07/20/2021